Understanding Depression in Children: Seeing Through the Muddy Waters of Bipolar Depression and ADHD

Depression is a condition that we most often associate with teenagers and people in their 20s, but it can strike children as well – particularly children who have been through traumatic experiences.

Expert estimates put the rate of depression in children at somewhere around 2-3% of the population.

In this article we’ll look at some of the typical events that can bring on childhood depression, what the usual symptoms are, the different types of depression that affect kids and how parents can proceed if they suspect their child may be suffering from depression.

A Life Event Might Trigger Child Depression but Is Typically Not the Only Factor

It’s important to realize that it can be very hard to point to any one factor in a child’s life and say, ‘This is the cause of depression.’

Usually depression results from a combination of factors, including genetics and the child’s reaction to particular life events.

We say ‘reaction’ to life events, because two similar children may go through similar life events, and one will become depressed while the other continues life ‘as normal.’

In other words, the onset of depression tends to be a combination of underlying factors that build up over time, with trigger events that can happen very quickly. But it’s not correct to say that a trigger event, on its own, ’caused’ the depression.

Trigger Event Example 1

A trigger event, for example, may be something like that death of a parent.

This is a very traumatic experience for a young child and may lead to depression even in a child who has previously had a resolutely positive outlook on life.

Trigger Event Example 2

Another example of a trigger event could be a car crash, or even something that seems relatively minor in the eyes of a parent such as changing schools.

In fact, it’s important to be in tune to what’s really important to your child in order to recognize triggers and risk factors.

Trigger Event Example 3

Moving to a new town for a new job may seem like a big life improvement for you and your family, but for a child it may mean leaving behind her friends and then only life she has ever known – a very different perspective.

Trigger Event Example 4

Even an event such as not being accepted onto a particular school sports team or missing out on a part in a school play can seem like a catastrophic event to a child, even if you as an adult see it as being very minor.

Child Depression Symptoms Can Be Elusive and Difficult to Label

It’s also important to understand that child depression may not manifest itself in a form that you might commonly associate with the term ‘depression.’

For example, irritability and agitation can be symptoms of depression in kids. It doesn’t necessarily appear in the form of prolonged sad moods, although that is common.

Sometimes it can be difficult to tell the difference between depression and ADHD (and we will discuss how these two disorders can relate to each other later in this article).

Here are some general symptoms to look for that can be indicators of depression in children:

Extended negative moods and feelings of sadness

A sense that the future holds nothing positive or feelings of hopelessness

Feeling that the future is out of their control

Anxiety or feelings that people are ‘against’ them

Changes in sleeping patterns – excessive sleep, inability to sleep or waking regularly throughout the night

Now let’s look at a couple of other common behavioral and emotional problems which are common in today’s children: manic depression in children (also known as bipolar disorder) and ADHD (attention deficit hyperactivity disorder).

Manic Depression in Children Is Difficult to Diagnose Because Most Children Can Switch Between Moods Very Quickly

Manic depression, or bipolar, is easy to confuse with clinical depression because it shares many of the same symptoms.

Manic depression in children is different because in addition to the low moods of depression, it includes periods of high energy and even states of euphoria.

Manic Depression Is Like a Fast-Moving Rollercoaster of Feelings

The disorder is characterized by changes between these high and low states – which often happen very rapidly and with no apparent reason for the change.

While euphoric moods can be symptomatic of manic depression, more often the ‘mania’ manifests itself in the form of irritability and temper tantrums.

A child which has a tendency to ‘throw tantrums’ and then switch very rapidly to ‘sulking’ and tears may be suffering from bipolar – however, of course, it’s important not to jump to conclusions.

Virtually every child displays these kinds of behaviors at different stages of their development. It’s only when they are particularly severe and last for prolonged periods that medical intervention is likely to be required.

Muddy Waters – Manic Episodes Look like ADHD

Bipolar children in a manic episode will also tend to have a hard time concentrating and may appear hyperactive – which, again, can muddy the waters a little, as parents and teachers often tend to jump to the conclusion that ADHD is what causes these behavioral issues.

Again, there is a lot of overlap between the symptoms of clinical depression, bipolar symptoms and ADHD symptoms. What makes bipolar stand out are the quick changes from one set of symptoms to another.

Sudden ‘Growth’ of the Sweet Tooth Can also Be a Sign of Bipolar

Food cravings can also develop as a part of bipolar – in particular a craving for sugar.

Obesity can become a risk in these cases, and again there is the threat of the depression and obesity ‘feeding each other’ and resulting in a further downward spiral in emotions and behavior.

A Physical Symptom Like Bed-Wetting Is also Seen among Children with Bipolar

There are some other common symptoms of bipolar in children which are less common in adults with the disorder.

One of these is bed-wetting. If a child who has previously had no problems with bed-wetting suddenly starts soiling his or her sheets at night, and also displays some of the symptoms described above, it could be a cause for concern.

Of course, a physical symptom like this may also be caused by a physical disease.

Whenever you visit a doctor to talk about depression or any psychological disorder, their first steps will typically be to test for physical diseases that may produce the same symptoms. This allows them to rule out the presence of a virus or infection, for example, before moving on to potential psychological explanations for the symptoms.

Disrupted Sleeping Patterns Can also Be an Indication

Disturbances in sleeping patterns can also be a common symptom, and these may be accompanied by nightmares or ‘night terrors.’

Children may also develop obsessive or compulsive behaviors – behaviors that they feel they have little control over.

Simple changes in behavior may also be symptoms of manic depression in children, such as adopting manipulative behaviors or becoming extremely demanding.

As mentioned, it can sometimes be difficult to distinguish between symptoms of depression in children and those of ADHD.

This is made even more complicated by the fact that children can suffer from both disorders at the same time, resulting in a mix of symptoms that often leaves parents tearing their own hair out in frustration.

Some experts now believe that many children with ADHD also have depression – as many as 30% of ADHD sufferers.

However, the lines of cause and effect are still not completely clear. (In other words, it’s hard to say if depression develops as a result of the ADHD and its related experiences, or if ADHD is actually caused by depression).

The differences between a child who suffers both ADHD and clinical depression, and a child who suffers from manic depression, can be very hard to distinguish.

This is something a medical professional will determine when you take your child in to be assessed – there is little value in trying to make a subtle medical assessment like this on your own, as it requires a trained eye and an intimate knowledge of the diagnosis criteria for each disorder.

Childhood Depression and Obesity: Conditions that Bite Each Other’s Tail

One of the most disturbing trends in recent years is the increasingly apparent link between childhood depression and obesity.

The Link Can Run Both Ways

Obesity itself can be a trigger factor which leads to the onset of depression.

And, conversely, depression can drive a child to seek the instant pleasures of fatty or sugary foods, which only leads to more severe obesity and, often, more severe depression.

It’s important to understand why obesity can be such a strong contributing factor to childhood depression.

For starters, obesity is usually the result of not only overeating, but also under-exercising. Since exercise is associated with the release of ‘happy hormones,’ a lack of exercise can lead to low levels of the brain chemicals that relate to upbeat and positive moods.

Also, the social element of obesity can be a big part of the problem. Often obese children are the target of teasing and abuse from children in their school, or even other members of their own family.

These attacks on self esteem can trigger or deepen depression in obese children.

Of course, the simplest way to reduce the risk factor posed by obesity is to get your child to eat healthy and get into the habit of exercising regularly. Simple – but certainly not easy.

However, many parents act as ‘enablers’ when it comes to childhood obesity – they don’t have the courage to say no to a demanding child, and as a result they allow a poor diet and lack of exercise to continue, even if they don’t actively encourage these things.

Childhood Depression Treatment

It can be quite tough for a child to be diagnosed with depression, and in many cases it’s almost equally tough on the parents.

But there are proven medical methods and strategies that can be used to deal with depression in children, which often allow kids to develop out of the disorder into a happy, healthy adulthood.

Childhood Depression Treatment Tends to Focus on Psychotherapy Although Medication Can Be a Strong Component in More Severe Cases

Many doctors are reluctant to prescribe drugs for dealing with childhood depression if they think it can be avoided – and this is a good rule of thumb, as antidepressants and other medications can come with their own set of problems if a dependency develops.

In many cases, the right form of therapy on its own is enough to bring a child out of his or her depression.

Why Doctor’s Are Reluctant to Proscribe Antidepressants

When medication is thought to be necessary, antidepressants, such as Prozac, are the main category of drugs used to treat depression.

However, it is important to be aware that studies have indicated antidepressants may lead to a higher suicide risk in the first few months they are being taken.

This is a big part of the reason many doctors see medication as a last resort in treating children with depression.

Cognitive-Behavioral Therapy for Children Are One of the Most Effective Methods of Psychotherapy

In terms of psychotherapy options for depression in children, there are a multitude of different approaches and methods that can be used.

One of the most effective of these in dealing with depression in children is cognitive-behavioral therapy.

This helps children analyze and understand their own thought processes and what they believe about themselves and the world.

Often a child’s depression is fuelled by negative beliefs – for example, an obese child may have a very negative self image as the result of severe bullying, and she may feel she will never be thin or worthy of love as a result.

Cognitive-behavioral therapy can help to remove negative beliefs and replace them with more constructive, positive beliefs, which in turn help children change their behaviors and build real-world reference experiences which reinforce their new positive beliefs.

This is how a ‘downward spiral’ can be reversed into an ‘upward spiral’.

What Would You Like to Read Now After This Article on Depression in Children?